Individual provider Active NPI

Cyndra A Shisler-Santistevan, MSW

  • Social Worker
  • Pueblo, CO
National Provider Identifier
1750821989
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
NLC.0011741 Issued in CO
Practice address
2330 Acero Ave
25
Pueblo, CO 81004-4177
Phone
(719) 406-4767
NPI assigned
Mar 7, 2017
Last updated
Mar 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NLC.0011741 CO Primary

Addresses

Primary practice location

2330 Acero Ave
25
Pueblo, CO 81004-4177

Mailing address

2330 Acero Ave
25
Pueblo, CO 81004-4177
Phone (719) 406-4767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
NLC.0011741COMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1750821989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 ACERO AVE",
            "address_2": "25",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810044177",
            "telephone_number": "719-406-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 ACERO AVE",
            "address_2": "25",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810044177",
            "telephone_number": "719-406-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHISLER-SANTISTEVAN",
        "first_name": "CYNDRA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "NLC.0011741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.